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Organization

LIFECARE ABA THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WAEL ELZENY (CEO)
(313) 318-8448
Entity
Organization

Contact information

Practice address
29125 BUCKINGHAM ST STE 2A, LIVONIA, MI 48154-4480
(734) 744-4339
Mailing address
427 SANDALWOOD RD, CANTON, MI 48188-3028

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
103T00000X
Psychologist
106E00000X
Assistant Behavior Analyst
171M00000X
Case Manager/Care Coordinator
225100000X
Physical Therapist
225200000X
Physical Therapy Assistant
225X00000X
Occupational Therapist
225XM0800X
Mental Health Occupational Therapist
225XP0200X
Pediatric Occupational Therapist
235Z00000X
Speech-Language Pathologist
251B00000X
Case Management Agency
252Y00000X
Early Intervention Provider Agency
253Z00000X
In Home Supportive Care Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM1300X
Multi-Specialty Clinic/Center

Other

Enumeration date
01/28/2025
Last updated
09/23/2025
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